Texas Department of State Health Services Mobile



Instrument Background and Objectives 2

General Instructions 3

Universal Columns 4

Visibility Zone Chart……..……………………………………………………………………………………………….… 6

Item Specific Instructions:

PRODUCE – FRESH FRUITS 7

PRODUCE – FRESH VEGETABLES 7

PHOTOS of Acceptable & Unacceptable Produce 8

GRAINS – CEREAL 9

GRAINS – BREAD 10

GRAINS – DRY GRAINS 10

GRAINS – DRY BEANS 10

FROZEN PRODUCTS – FROZEN FRUIT 10

FROZEN PRODUCTS – FROZEN VEGETABLES 11

FROZEN PRODUCTS – FROZEN 100% FRUIT JUICES 11

FRESH FRUIT & VEGETABLE JUICES 11

DAIRY (MILK) 12

Completion Checklist 12

Instrument Background & Objectives

This tool is a modification of the TxNEA (Texas Nutrition Environment Assessment), which was a modification of the NEMS (Nutrition Environment Measurement Survey), originally developed at Emory University. The objective of the NEMS was to measure differences in the nutrition environment (stores and restaurants) between different SES-level neighborhoods. The TxNEA was an adaptation of the NEMS tool that included additional foods that were culture-specific to the minority populations of Texas (Hispanic and African-American).

The TxNEMS-WIC store audit tool, a modification of the TxNEA, was designed to measure the availability, accessibility, and affordability of WIC-allowable food items. WIC is a federally-funded health and nutrition program for women, infants, and children. A new WIC package, which incorporates additional healthy food options, will be implemented in late 2009. The objective of this store audit tool is to measure the impact of the new WIC package on the availability of WIC items to WIC participants. The TxNEMS-WIC store audit tool focuses on those WIC items allowed for children – not those items allowable for infants or lactating mothers – and it also compares some items of the WIC package to some of the less healthy counterparts to those items, specifically sugary juice options and sugary cereal options.

To prepare for every store audit be sure to have the following items with you:

o site visit schedule

o maps

o blank audit tools

o pens/pencils

o folding ruler

o calculator

o clipboard

o training guide

o letters for store managers

o watch

o digital camera

o University I.D.

✓ Permission should be obtained from store managers before data collection begins (present letter of explanation). Remember to obtain the name of the person giving permission so you can write it on the top of page 1.

✓ Be courteous and professional at all times.

✓ Avoid early morning audits, which would likely interfere with shelf stocking.

✓ Always make an effort to avoid being in the way of customers or store personnel – we don’t want to interfere with the normal flow of business in any way.

✓ Leave store shelves as you found them, returning items to their place after collecting the information you need.

✓ Record start and stop time at each location and circle the am or pm next to the blank boxes.

✓ Check to be sure survey is complete before leaving each location.

✓ Take a photo of every shelf space for every item you measure.

✓ PLEASE EXERCISE CAUTION when using the folding ruler; be sure that there are no customers or employees near the display space you are measuring.

General Instructions for Beginning the Audit

✓ Record your Rater ID number, the Store ID number, and the Date at the top of each page of the tool.

✓ Record Start Time (and End Time later) at top of Page 1.

✓ Record name of store employee that gave permission to proceed with data collection (also at top of Page 1).

General Instructions for Ending the Audit

✓ Review the “Completion Checklist” found on Page 12 of this Training Guide before leaving the store!

Universal Columns are those found throughout the audit tool. For the sake of brevity, they are discussed here and not repeated in the individual pages of instruction, which are reserved for specific instructions for each category of product. Please familiarize yourself with the universal columns and the measuring instructions found on pages 5-6. The Universal Columns are:

WIC LABEL: This column is used to determine if the store identifies WIC approved products for their customers. Check this box if there is a WIC label (usually pink) on the display of the item you are rating – the goal is to determine if WIC items are clearly labeled, thus making them easier for shoppers to identify. [Notes: 1) Items that are new to the 2009 WIC package are not expected to be labeled in the pre-measures; 2) The Cereal section has special instructions for this column; see page 9.]

ITEM: This column indicates the product of interest which varies by page and/or by section. Read item descriptions carefully, noting if they are a specific size or a specific unit type (e.g. box, bag, can, pkg.) that you are measuring.

NOT AVAILABLE: This column indicates whether or not items are carried by the store and if so, if they are currently in stock. Check the “Not Available” box when an item is not present in the store. Also circle “o/s” if the item is not available because it is out-of-stock. If it is not clear why the item is not available, only check the box.

LOWEST PRICE: This column is used to determine the lowest price of products regardless of whether it is a name brand, store brand, or generic brand product. We also refer to lowest price item as Least Expensive Brand, or LEB.

• Price columns will vary depending on the product. Some columns ask for lowest price per pound and some for lowest price per ounce. Others ask for lowest price per package or unit (e.g. box, bag, can, pkg.) so be sure to read this column carefully, and record prices accordingly.

• If you cannot find a price for an item, ask store personnel for help.

DISPLAY SPACE: This column is used to determine how much shelf space a product is given. You will use a folding ruler to measure shelf width and visibility of all display areas.

Visibility (low, medium, high): To measure Visibility of display spaces, extend the ruler to its fullest capacity and hold the red end on the floor in front of the display area to be measured. Hold the ruler as straight as possible, and stand at arms length to see within which visibility zone(s) the merchandise of interest falls. Note: You are assessing where the product lies, not necessarily the full height of the display shelf. The visibility zones are Low, Medium, and High. The folding ruler provided has been painted red (low visibility), yellow (medium visibility) and green (high visibility) to correspond with these visibility zones (see visual on following page). To measure visibilty, hold the ruler next to shelving with the red portion resting on the ground. Items falling within the green portion of the ruler are in the high visibilty zone and can be indicated on the form by circling the “H” under the visibility column; likewise, items falling within the yellow portion are in the medium visibilty zone (M) and the red portion the low visibility zone (L).

✓ NOTE: The ruler is only 6.0 feet in height; therefore 6 inches above the ruler is medium visibility and anything above that is low visibility.

~ ~ ~ See illustrations on next page ~ ~ ~

Width (in inches): Turn the folding ruler so that it is parallel to the floor to measure and record the width of all display areas for item you are rating. Measure along the front of the shelf where the product faces. Important Note: Round UP to record measurements to the nearest half-inch. When you find items in several places, such as apples in several crates or boxes, each width should be measured and recorded in the boxes located in the display space section of the form. Only record the widths and do not worry about adding the widths together. This will be done by lab personnel at a later time. Note: If there are many shelves that are of obvious equal width for the same product, you may measure one, count the number of equal shelves, and record 18 x 24” (this example indicates that there were 18 separate shelves/bins that each measured 24” in width).

| |

|Red – Low Visibility |

| |

|Yellow – Medium Visibility |

| |

| |

|Green – High Visibility |

| |

| |

|Yellow – Medium Visibility |

| |

|Red – Low Visibility |

Visibility zones indicate if products are readily visible to consumers. For the purposes of this audit, the visibility zones are based on the height of the average woman in Texas – 5’3” – which is slightly shorter than the national average and a more accurate depiction of our target populaion. Store shelves are approximately 7 feet in height.

Three visibility zones are: high visibility (green), medium visibility (yellow), and low visibility (red). Products falling within the high visibility zone are 2.0-5.5 feet from the floor; medium visibility zones 1.0-2.0 feet or 5.5-6.5 feet, respectively; and low visibilty under 1.0 or over 6.5 feet.

NOTE: The ruler is only 6.0 feet in height; therefore 6 inches above the ruler is medium visibility and anything above that is low visibility.

Measure #1-A: PRODUCE – FRESH FRUITS

Measure #1-B: PRODUCE – FRESH VEGETABLES

|Total # of Varieties |

|I I I I |

|I I I I I I I I I |

|16 |

Total # of Varieties: This column is distinct for produce section. Write a tally mark in the box next to the produce item to keep track of the varieties for each fruit. A variety is considered the same type of fruit (e.g. apple) that has a distinct name (e.g. Gala, Granny Smith, Golden Delicious) . A single variety may have differences in size (e.g. small and large Haas Avocados) however, these are not counted as two separate varieties. After tallying the number of varieties of all fruits, write the sum of these totals where indicated.

Also NOTE: Most fresh produce is priced to sell by weight. If you encounter a fruit or vegetable item that is priced individually (e.g. one head of lettuce for $1.49) follow this procedure:

Select 3 pieces that look typical size compared to the majority. Weigh these pieces and calculate average weight per unit (total weight ÷ 3 = average weight per piece). Then calculate price per pound (price per piece ÷ average weight per piece = price per pound). Write “N/A” if price is not available. Use the lines at the bottom of the instrument page to write all calculations needed and indicate the item each calculation pertains to.

Example of calculations for items priced per piece:

Peaches found in one store at 79 cents each:

| .25 lb. |

| + .31 lb. |

| .19 lb. |

| .75 lb. |

Three weights added together (.75 lb.) and divided by 3 gives the average weight per piece {.75 lb. / 3 pieces = .25 lb.} Next, divide the price per piece by the average weight per piece, which will give you the price per pound. {.79 / .25 lb. = 3.16} $3.16 equals the price per pound.

Exception: For watermelon and cantaloupe, weigh only one piece to calculate price per pound. If the watermelon are too large to weigh even just one, indicate price per unit (make it clear that it is a unit price).

Display Space: There may be more than one section for the same product. Measure all display areas for each product, but ignore special sale bins of the same product that are priced lower than the rest of the product in the store (e.g., over-ripe fruit set to the side on sale).

Quality: This column is distinct for produce section. Check the “Acceptable Quality” box if more than 50% of the produce item you are rating is found to be of acceptable quality, using the following criteria (also refer to photos):

[pic] [pic]

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Measure #2-A: GRAINS (CEREAL)

NOTE: There are different methods for collecting and recording lowest prices for WIC and Non-WIC cereals:

• For WIC cereal boxes/bags: The WIC cereal items must be the exact size listed in the “item” column. Only record the lowest price for the exact size indicated. If the exact size is not available, check the N/A box in “Not Available” column. Close sizes (e.g. 17.5 oz. when the tool specifies 18 oz.) cannot be used as a substitute for WIC products. Please note if the item is a box or bag (also indicated in the “item” column) and record information accordingly.

Example: Item #1 on the cereal page of the audit tool

In the store, there are four boxes of plain corn flakes:

1. A 18 oz. box for $1.89

2. A 17.5 oz. box for $1.88

3. A 18 oz. box for $2.59

Which do you record? Since #1 on the audit tool specifies an 18 oz. box, only #1 and #3 above are considered. #1 is the lowest price of the two so $1.89 should be recorded in the “Lowest Price per Unit” column.

NOTE: For cereals, it is not a requirement that the WIC label be placed by the least expensive brand. Please indicate the price of the cereal nearest to the WIC label in the first column, and then indicate the least expensive brand price in the Lowest Price per Unit column.

• For Non-WIC cereal boxes there is an allowable size range of 16 to 20 ounces. Use the space provided at the bottom of Page 3 to record price of package, size of package, and price per ounce of any product you find within this range (Note: You should calculate the price per ounce, even if the store label provides this information). Then record the price per ounce of the least expensive item in the “lowest price per unit” column above.

Example: Item #16 on the cereal page of the audit tool

In the store, there are three boxes of frosted corn flakes that fall within the specified range of 16-20 oz. Record total price and size for each, and then calculate price/oz (Price Pkg. / Size Pkg. = Price/oz.), as follows:

16. Frosted corn flakes, 16-20 oz. range

Price Pkg. Size Pkg. (oz) Price/oz

____2.40____ ___16__________.150__

____2.44____ ___17.5________.139__

____3.89___ ____20__________.195__

Although the first item is the least expensive per box, the second item is the least expensive per ounce. Record .139 in the “lowest price per unit” for Item #16.

Measure #2-B: GRAINS - BREAD

NOTE: To determine if bread is whole grain/whole wheat, count only items with one of these phrases on the package:

• 100% whole grain

• whole grain

• 100% whole wheat

• whole wheat

NOTE: Each bread item has a size range (e.g. 16-24 oz.). To determine which item has the lowest price per ounce, simply divide the price by ounces:

|Price |Calculation |Result |

|$2.89 (16 oz.) |$2.89/16 oz. = $0.18 per oz. |Since $0.149 is cheaper per ounce|

| | |than $0.18, record $0.149/oz. |

|$3.59 (24 oz.) |$3.59/24 oz. = $0.149 per oz. | |

Measure #2-C: GRAINS - DRY GRAINS

NOTE: Only assess bagged brown rice (not boxed).

Measure #2-D: GRAINS - DRY BEANS

NOTE: Only assess 1 lb. packages.

NOTE: Measure visibility of LEB only.

Measure #3-A: FROZEN PRODUCTS – FROZEN FRUIT

NOTE: Do not include items that have added sugar or sauces.

Measure #3-B: FROZEN PRODUCTS – FROZEN VEGETABLES

NOTES:

✓ Do not include items that contain sauces (e.g., butter or cheese).

✓ For Frozen Corn, note that packages may contain yellow, white, or a combination of both to be counted. Remember, however, to only record the lowest price per package available.

✓ For Mixed Vegetables, note that packages may contain any combination of 2 or more vegetables together. (Example: peas and carrots, or corn, peas, carrots and lima beans) This does not include packages that may contain sauces such as Stir Fry Mix containing Teriyaki Sauce.

Measure #3-C: FROZEN PRODUCTS – FROZEN 100% FRUIT JUICES

NOTES:

✓ Measure visibility of LEB only.

✓ Do not include items that contain added calcium.

✓ Grapefruit juice concentrate can include white and pink fruit varieties.

✓ For Purple & White Grape juice, circle the size (11.5oz or 12 oz) of the LEB you measured in the item column.

Measure #4: FRESH FRUIT & VEGETABLE JUICES (Fluid; Non-Refrigerated*)

NOTES:

✓ This section is for non-refrigerated juices and juice drinks (*with the exception of Sunny D and Lemonade – they are refrigerated).

✓ Items #1 through #9 are normally only found in 46 oz. cans, but because WIC will be allowing 48 oz. cans later, as well, we are interested in both sizes. Please circle the size of each that you are measuring (LEB). It is not likely you will find BOTH sizes on the shelf at the same time.

✓ Measure visibility of LEB only.

✓ Only include items that match descriptions exactly. If there is an extra or missing fruit, do not include that item E.g. “peach pineapple juice” would not be included since peach is an extra fruit. Likewise, “mango juice” would not be included, because it is missing the necessary fruits orange or pineapple to be counted for either #7 or #8.

✓ Items #5 (orange pineapple juice) and #6 (pineapple orange juice) are two separate items, to be measured separately.

For non-WIC items (Hawaiian Punch, Sunny D and Lemonade) record information on the LEB on specified sizes only . Reminder: Item 10 (Hawaiian Punch, 1 gallon) is a non-refrigerated item usually located next to the WIC-allowable juice, and Items 11-14 are refrigerated items, usually located in or near the dairy case.

Measure #5: DAIRY (MILK)

NOTE: Measure visibility of LEB only.

For the purpose of this survey: Oldest Sell-by Date = Expiration Date

Oldest Sell-by/Expiration Date: Note the oldest sell-by/expiration date (month/day/year) in the front row of the item you are rating. You may pull forward items to fill the front row, if necessary.

Total Units Expired/Total Units (front row): If you find expired container in the front row (after pulling forward items as necessary), record the number of units expired and the total units present in the front row (e.g. 2/5). Note: If there are no expired units, you do not need to record anything in this column.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Completion Checklist

Review the following items and be sure you have followed each step before leaving the store:

1. Are the Rater ID, Store ID, and Date recorded at the top of each page?

2. Are the Start time and End Time recorded on the first page?

3. Is the name of the store personnel who authorized the audit filled in?

4. Is each page of the audit tool completely filled out? (all product sections)

5. Did you measure Display Space for LEB items only for Dry Beans (Page 5), Frozen Products (Page 7), Fresh Juices (Page 7), and Dairy Products (Page 8)?

6. Is the data in your price calculation boxes at the bottom of pages 1 through 4 complete and easy to read?

7. Did you take photos of every display for which you collected data?

8. Please say thank you to store personnel on your way out!

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Training Guide for Auditors

Table of Contents

Instrument Background & Objectives

General Instructions

Universal Columns

Example 1:

In a display such as this one, you would measure width on all 4 sides of the display (not just the two longest sides), because there are separate shelves facing all 4 sides.

Example 2:

If you encounter an octagonal shaped display, measure the longest possible distance across. In this example, you’d measure one side only.

Example 3: Measure the diameter only of a round display

VISIBILITY ZONE CHART

5 ft

6 ft

7 ft

4 ft

3 ft

2 ft

1ft

Red

Green

Red

Yellow

Yellow

MEDIUM

LOW

HIGH

MEDIUM

LOW

Page 1

Page 2

Unacceptable (below): bruised, old looking, mushy, over-ripe, dark sunken spots in irregular patches, cracked or broken surfaces, signs of shriveling, mold, or excessive softening.

Acceptable (below): good color, fresh looking, firm, and clean.

Page 3

Page 4

To verify if an item qualifies, check the ingredient list: If the first item includes the word “enriched,” it is NOT a whole grain product.

Page 5

Page 5

Page 6

Page 6

Page 7

Page 7

Page 8

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